What CDC and Other Agencies Did in Response to the Outbreak of E. coli O157:H7 Infections From Spinach

How CDC & Other Agencies Responded to the 2006 Spinach Outbreak

NOTE: This document is provided for historical purposes. The content of this document has not been revised since its original release and therefore may no longer be up to date.

CDC has been using two food safety systems, PulseNet and OutbreakNet, to respond to the outbreak of Escherichia coli O157:H7 infections. Following a call from Wisconsin’s state epidemiologist on Friday September 8 regarding four cases of hemolytic-uremic syndrome in the state, CDC has been working collaboratively with state health departments and the Food and Drug Administration (FDA) to rapidly detect infections, identify the cause of the infections, and provide information on treatment and prevention of E. coli O157:H7 infection for the public and health care providers.

The PulseNet system, part of the Association of Public Health Laboratories and coordinated by CDC, detected clusters of infection in two states, Oregon and Wisconsin, which initiated investigations in each state. The first cluster was detected on Friday September 8 in one state, and the second cluster emerged in the second state on Wednesday September 13, by which time PulseNet had also identified potential associated cases in other states.

The OutbreakNet, a group of state public health officers who investigate foodborne infection outbreaks, shared information with CDC that indicated that Oregon and Wisconsin were considering the same hypothesis: fresh spinach was the possible vehicle of infection. The group tracked and updated the increasing case count and exposure information. During a multistate call on Thursday, September 14, the group noted that the data strongly suggested that fresh spinach was a likely source. Within 24 hours of the outbreak, the data indicated that the outbreak was probably ongoing.

A CDC liaison to the FDA coordinated discussions with FDA officials to determine the next steps within one hour of the conclusion of the multistate call on Thursday September 14. The call reinforced the need for swift action to notify the public and industry. An investigation at a produce packing plant in the likely state of origin of the spinach began that same day.

CDC made communication to the public a priority by developing press releases, coordinating with FDA on press documents, conducting interviews with major media, and sending out notices on Thursday September 14 to the public health community via the Health Alert Network (HAN) and the Epidemic Information Exchange (Epi-X). By the next morning, the news media warned the U.S. population not to eat bagged spinach, with remarkable coverage.

The outbreak is still going on, and there is still a great deal of epidemiological and laboratory work to be performed quickly to determine the source of the outbreak and to control it.

Page last modified September 18, 2006
Content source: National Center for Infectious Diseases